"I like a good story, well told. That is the reason I am sometimes forced to tell them myself." - Mark Twain

Monday, October 20, 2014

Ebola: This Is What Science Sounds Like

This excerpt is 28 minutes on this Ebola outbreak that are worth your time if you want some straight shooting, from Michael Osterholm, speaking at CIDRAP of Oct. 14th (last Tuesday).Highlight thoughts:1) "The more I study about Ebola, the less I know about it."2) "Reality must take precedence over public relations, for nature cannot be fooled." (Tom Frieden, Anthony Fauci, call your office.")3) Everything we know about Ebola so far is based on a total of 2400 patients from the past 24 outbreaks over 40 years. the longest set of generations has been 5.(For reference, we are at 9000-20000+ patients, and we're on generation 20-25, this time around).4) People are never frightened by statements like "I don't know, but this is what I'm doing to learn."But they do get scared if you tell them A or B with certainty, and it doesn't happen; or if dueling experts tell you A and Z simultaneously.5) We don't know what will really work. We should try everything we can.@ 9:46 "I believe the only thing we can do today is continue to try the treatment bed approach, to try to do as much as we can to isolate infected individuals, and quarantine and so forth...we've gotta do what we can."6) It's time to reconsider our response, and if we hadn't been so dogmatic about things we didn't know, that wouldn't be so hard.7) There's no Plan "B". If West Africa is a gas can that was waiting for a match, the rest of Central Africa is a gasoline tanker waiting for a match, and nobody anywhere has a Plan B for what happens if this gets out further, and they're not even thinking about it. We need to start thinking about those answers now.Can we fight it on two fronts if it gets out? We can't even fight it on one front now.8) I believe we can have an effective vaccine; but there's a big difference between getting a vaccine, and actually how and where we're going to make it, how we're going to get it there, and who's going to get it into Africans now. We need to imagine that Kinshasa is on fire tomorrow, and do all of these things at the same time, not doing one after the other.9) We have a problem with couching things in certainty for which certainty does not exist.10) Some Ebola patients don't present with fever, ever.Now is the time to tell people that, instead of waiting until that explodes, and the media asks you "Why didn't you tell us the complete truth?"11) Aerosols are created, and research has indicated that with Ebola, airborne transmission has been observed between laboratory animal species. We shouldn't not tell people about this, because top Ebola virologists have studied this, seen it, and are very concerned about the possibility. What are we going to do ("Plan B") if we do have an airborne transmission, and we suddenly have a reason to be very concerned about airplane cabin transmission? We need to start making that plan before it's a problem.If this guy was the head of the CDC, or at the very least, their communications director/official spokesperson, the level of intelligence and response on this, and the public perception about this, would have improved 1000%.We DO NOT KNOW:* where Ebola lives between outbreaks * what vector gets it from that host to humans* how it gets transmitted to or between humansEverything we do "know" is based on less people than the number who had it as of August 18th, most of whom were dead before much could be learned.The kind of scientific humility AND forethought Dr. Osterholm lays out in this talk is something sorely missed so far, and desperately needed in the discussion.Even if we don't have the answers, guys like this ARE ASKING THE RIGHT QUESTIONS, which is a vast improvement over the recent Clowncarnucopia Of Fail that's been on parade non-stop for the past 3+ weeks at every level of this crisis.h/t to Anonymous commenter who posted the link to the vid.

8 comments:

Anonymous
said...

Quick question: what do you consider the best source for stats (infected/dead/by country) on the outbreak? I want to do a little number crunching and can't yet find one that I like.

This video is great stuff. All this info is sorely absent from the broader reporting and discussion on the outbreak...especially point #10, as the news readers celebrate today's release from quarantine of Duncan's besties.

Jeez...your blog has become suuuuuch a downer...aren't you about due for a movie review to lighten the mood? Can I suggest a mediocre mid-90s flick with Dustin Hoffman and Renee Russo...?

My mother was a microbiologist for the NIH. She was born in 1931 and told me horror stories about the polio outbreaks she experienced during her childhood in NYC. I survived bacterial meningitis with septicemia and went on to be a research chemist for DuPont. Infectious disease is of paramount concern always. A vaccine will take time (years) if ever. This C-Span discussion is the first rational, mainstream discussion I have heard on this subject. Dr Osterholm should be our voice of reason. I wish he were more involved.

@AnonymousYou can go direct to the WHO site, or wait a day or so and see the same numbers put up on Wikipedia's Ebola Virus Epidemic in West Africa page. Crunching those numbers was how I knew two months before WHO did that they weren't going to contain this at 3000 cases, or even 20,000, and knew it two months before they did. They're all there is, with the caveat that both WHO and CDC acknowledge that the actual numbers, vice the "official" published ones, may be 2-2.5 times higher in reality.In other words we may already be nearing 25K cases, not 10K.

As for the rest, unlike administration spokesholes, I can't sugarcoat the dreadful realities. And the flick you mentioned was so-so, not mediocre (i.e. a C, not a D).As for good news, Nigeria, and probably Senegal, are at the moment Ebola-free. (Unfortunately Mali and Cote d'Ivoire probably aren't). But the takeaway with regard to Nigeria is that they achieved that status by draconian quarantines, the exact type we've refused to do, and they experienced transmission and death rates over 6 times worse than what we got, for precisely one case. In other words, nothing much to write home about.

…but the accompanying image is quite interesting — of a streetside "chalkboard newspaper" ("Ebola: 1; USA: 0") in Monrovia (capital of Liberia, one of the three hardest hit countries in west Africa, two of which host US biological weapons labs).

Late night news (first I've watched in months) was touting the nightmare "over" as the majority of people exposed to patient zero went home. Sounds like wishful thinking to me... it CAN'T end (in the USA) this easily, can it?

Gee, what are the odds that something called "The Daily Talk" bitching about the US half-way 'round the world would be a communist rag which RT then immediately knows about -- because those tentacles belong to the same octopus?

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Not counting the news outlets or websites along the full range of accuracy and veracity, I follow 10 or so actual individuals' handwritten blogs. Looking them over, 8 of the 10 are current serving or former military and 4 of those 8 are some variation of high-speed low-drag elite forces ninjas. And 2 are cops.So in other words, the same folks I trusted in the military not to wet the bed, sh*t themselves, or otherwise run around like headless Nancys, are the same folks I trust on the interwebz, for demonstrating pretty much the same trustworthiness and circumspectly responsible behavior.Color me shocked.

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